| National Provider Identifier [NPI]: | 1437344264 |
| Last Name Of The Provider | NEELY |
| First Name Of The Provider | MICOLE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 702 W CAMELBACK RD STE 20 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850132291 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 899 |
| Number Of Medicare Beneficiaries | 280 |
| Total Submitted Charge Amount | 87232 |
| Total Medicare Allowed Amount | 30217.54 |
| Total Medicare Payment Amount | 20242.84 |
| Total Medicare Standardized Payment Amount | 24805.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 313 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 11910 |
| Total Drug Medicare AllowedAmount | 341.68 |
| Total Drug Medicare PaymentAmount | 253.1 |
| Total Drug Medicare Standardized Payment Amount | 253.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 586 |
| Number Of Medicare Beneficiaries With Medical Services | 279 |
| Total Medical Submitted Charge Amount | 75322 |
| Total Medical Medicare Allowed Amount | 29875.86 |
| Total Medical Medicare Payment Amount | 19989.74 |
| Total Medical Medicare Standardized Payment Amount | 24552.78 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 137 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 177 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 232 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.9502 |